Why Cervical Cancer Screening is So Very Effective

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​Tamara Keown, Nurse Practitioner with the Center for Women's Health, reveals why early cervical cancer screening is so effective in preventing cervical cancer, who should be screened and when, how to reduce the risk of developing cervical cancer, and what's new in cervical cancer screening.

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Bridgette Butler: Welcome to this edition of the Vanderbilt Health and Wellness Wellcast. I am Bridgette Butler with Health Plus. January is Cervical Cancer Awareness Month, and today's Wellcast is a follow up to our Cervical Cancer Wellcast from January 2017. I am speaking with Tamara Keown, Nurse Practitioner, with the Center for Women’s Health. Welcome, Tamara.

Tamara Keown: Thank you. It's my pleasure.

Bridgette Butler: Tamara, much of cervical cancer awareness efforts are focused on screening. Why is screening for cervical cancer so important?

Tamara Keown: The Pap smear or Pap test was first introduced in the 50s, and since that time, cervical cancer rates have actually dropped 75%, and the Pap test will find changes in the cells of the cervix long before it becomes cancer, and those changes can be treated and removed so we can actually prevent cervical cancer from occurring.

Bridgette Butler: What types of screenings are available, and what do they entail?

Tamara Keown: Well, most everyone knows the Pap smear, which we often call the Pap test, but that is just one part of the well woman visit. It is specifically for finding those changes in the cells that become cancer if they are not treated. The Pap test involves collecting some cells from the cervix with a small spatula and a little brush. Just because a Pap test detects those changes, though, doesn't mean those changes will become cancer. Most of those will go away, given time. Also, for women over 30, we will do a test for an HPV test, or a human papilloma virus. That is done right off the same sample as the Pap. HPV, we now know, is associated with at least 99% of cervical cancer. It is actually so common that almost all sexually active people will be exposed at some time.

Bridgette Butler: Who should we be screened for cervical cancer?

Tamara Keown: Woman, starting at age 21, should have a Pap test every three years. Then when she turns 30, we will add the HPV test, and we call that co-testing. That test should be repeated every five years. If a woman has had this routine testing, and she turns 65, she does not need Pap testing any longer or cervical cancer screening any longer, but just because we don't recommend cervical cancer screening at every visit, doesn't mean you don't need a yearly visit, a yearly well woman visit, but you should discuss that with your provider to determine how often you should still come into the office.

Bridgette Butler: Are there ways to reduce the risk of developing cervical cancer?

Tamara Keown: Yes. Actually, the number one way to reduce the risk is to get vaccinated. We have an HPV vaccine that is for girls and boys from age 9 to 26. We target age 11 or 12 because that is when the immune response is the greatest to the vaccine. The side effects from the vaccine are really very similar to others like pain, fever, headache and fainting, although that is very uncommon.

Bridgette Butler: Since our last Wellcast in January 2017, what is new in cervical cancer prevention, screening, treatment? Have there been any new studies or developments in the past year?

Tamara Keown: Well, in the last few years, the FDA actually approved a specific test for HPV to use as a primary screen. That is different than using co-testing, which also includes a Pap. At this point, there is still some disagreement over which is the preferred way to test women for cervical cancer. So, currently at Vanderbilt, we are still recommending co-testing after 30.

Bridgette Butler: Thank you so much. This is great information on the importance, the great importance, of cervical cancer screening and the types of screening that one would get and when they should get them. We appreciate all of your insight and information today.

Tamara Keown: Thank you. I just want to sum it up and add that, remember, cervical cancer screening is such an easy way to find those changes in the cells of the cervix long before cancer occurs, and there are very few cancers that have such an effective screening tool.

Bridgette Butler: Absolutely. We will be sure to take advantage of that. Thanks again, Tamara!

Tamara Keown: Thank you.

Bridgette Butler: Thanks for listening. Please feel free to leave us any comments on this Wellcast on the form at the bottom of this page. If you have a story suggestion, please email it to us at health.wellness@vanderbilt.edu, or you can use the "Contact Us" page on our website at healthandwellness.vanderbilt.edu.